The audit found that the Department of Health and Human Services (Department) omitted accuracy standards and changed payment methods from contingency to hourly for post-payment reviews, despite known problems with contract work. The Department did not evaluate the accuracy of post-payment reviews that the contractor performed of durable medical equipment claims, nor did the Department have a formal quality assurance process to evaluate the accuracy of the contractor's prepayment reviews. Finally, the audit found the Department excluded penalties for nonperformance from its Medicaid claims prepayment review contract.